I love lots of things about being alive and being human -- but pain isn't one of them. Put crudely, pain really sucks. It's just not a pleasant thing. I'd really rather do away with it. Or at very least -- place it totally under conscious control, so I have it only when and if I want it.
It's not that I suffer from particularly much pain, compared to other people. I've been thinking about pain a lot lately, but more because of a friend with Chronic Regional Pain Syndrome (CRPS) than because of any of my own direct experiences. Fortunately, my own life is much more pleasurable than painful, so far at any rate.
But the more I think about it, the more I think pain is analogous to death -- it's something that's so integral to "human life as we know it" that we generally just take it for granted and forget how nasty it is. If immortality pills were available, almost nobody would actually choose death; and if pain could be eliminated or radically reduced without bad side-effects, almost nobody would choose to experience pain. (Well, OK, maybe now and then just for novelty!) And without pain and death in the back of our minds all the time, our whole experience of life would be different, and our selves and world-views would shift in dramatic ways.
It seems clear to me that the radical extension of healthy human lifespan is feasible. Death is largely avoidable, via technologies well within human grasp. But is the abolition -- or near-abolition -- of pain really possible? Could advanced technology somehow allow us to modify our brains to avoid the existence of pain, or place pain totally under conscious control -- without killing us or rendering us unconscious or idiotic or something else undesirable?
It's hard to know for sure -- but at the moment, my best guess is that the answer is YES.
To explain why I think this, I'll need to delve a little into the philosophy of pain experience, and into the nature of a strange brain disorder called "pain asymbolia."
The English word "pain" refers, primarily, to a subjective experience -- the experience of something hurting. But this experience isn't a simple, indecomposable thing -- it's actually a complex experience with multiple layers. Understanding the prospect of abolishing pain, involves carefully distinguishing these layers.
To abolish, or drastically reduce, our experience of pain, we will need to deal with pain in terms of its neural and cognitive correlates. Subjective experiences -- qualia -- are different from neural or cognitive structures or dynamics. But there are correlations. For instance, deep thought correlates with the neocortex -- if you remove it, the person doesn't think deeply anymore. The feeling of reminiscence correlates with cognitive structures related to emotion and episodic memory, and with neural regions such as the limbic system and the neocortex. And so forth.
What are the neural and cognitive correlates of the experience of pain?
In his book "Feeling Pain and Being in Pain", the philosopher Nikola Gracek reaches toward an answer to this question. He considers the conceptual implications of the disease called "Pain Asymbolia" -- in which a person is aware that a painful sensation is there, but doesn't experience the pain as hurting. They feel the pain, but they are not in pain. Furthermore, they can cognitively understand that the pain signifies damage to their body, that should be avoided ( in those cases where this is true). The pain is perceived and understood, but it doesn't hurt.
Gracek's book considers some very interesting questions, but I feel its conclusions are a bit muddled. There is a small academic literature following up his ideas, but it digs too deep into technical philosophy for my taste -- so after reading the book, I wound up thinking through the issues for myself, as I usually do.
One question begged in this context is: What aspect of the brain is it, whose abnormality correlates with pain asymbolia? What aspect of the structures and dynamics of the brain is different in people with pain asymbolia, corresponding to their different qualia regarding pain? The neuroscientists haven't quite figured this out yet, but there are some powerful clues. A lot of people with pain asymbolia seem to have damage to brain regions called the granular insula and parietal operculum.
It's also interesting to think about the issue on the cognitive level. What aspects of the mind's cognitive processing is it, whose abnormality correlates with pain asymbolia?
In this regard, it seems useful to distinguish four levels of pain processing:
This is a feedforward/feedback hierarchy, with each level passing information to and exerting influence on the levels above and below.
Purely emotional pain, without any direct physical cause -- say, the pain of losing a loved one -- starts at levels 3 and 4, but via feedback connections can often impact levels 1 and 2 as well. When emotional pain gets acute enough or goes on too long, it can genuinely physically hurt.
This hierarchical view lets us draw some speculative, tentative conclusions about pain asymbolia and other pain-related disorders. It seems that, in cases of pain asymbolia, levels 1, 2 and 4 are basically intact. This suggests the hypothesis that perhaps level 3 is not. Specifically, it seems that the feedforward of information from level 2 to level 3 does not work normally in people with pain asymbolia.
Somewhat similarly, it may be that in some cases of chronic pain (like my friend who has CRPS), the passage of information between level 2 to level 3 is dysfunctional in a different way. There may be mutually excitatory circuits between level 2 and level 3 that cause a perpetual sense of the body being in a damage/danger state due to pain signals, even when there are no pain signals coming from the basic pain sensors. This may also cause feedback to go to the pain sensors, causing actual low-level pain signals to emerge, stimulated entirely by the feedback from the dysfunctional higher levels.
So -- what is the cognitive correlate of being in pain? of the "ouchness" of pain, the fact that it actually HURTS? It seems the answer may be: some aspect of the unconscious mind/body representation of damage/danger associated with pain signals, as mediated by multiple brain regions such as the granular insula and parietal operculum. And this answer, if correct, may have dramatic implications regarding the possibility of eliminating or drastically reducing the role of pain in the experience of humans and other intelligent systems.
To complement the information obtained from studying people with pain asymbolia, it would also be fascinating and instructive to carry out neurological studies of other cases where people manage to avoid the ouchness of pain -- via meditation, martial arts, yoga and so forth. Anecdotally, several yoga practitioners have told me they can get in a state of mind during yoga practice, where they know their body is issuing pain signals, but it doesn't actually hurt. I wonder if this is impacting the same brain regions as are damaged in cases of pain asymbolia? -- or, perhaps, a different part of the brain's pain interpretation network?
Finally, though it's not my focus here, I can't resist noting that this line of thinking has some potential implications regarding the pain experiences of nonhuman animals. It suggests that reflective, high-level cognitive understanding of the damage and danger associated with pain signals, is not prerequisite for feeling the ouchness of pain. All that's needed is the ability to unconsciously, via an emergent holistic mind/body state, reflect the fear or anticipation of this damage/danger. It seems pretty clear that any macroscopic animal can do this, and quite possible that even micro-organisms can. It may be that we are causing tiny pieces of pain-experience to huge numbers of bacteria, moment by moment, as an unavoidable consequence of our human existence.
The neural and cognitive science of pain is an fascinating topic. But even more interesting, to me, is the process of engineering pain out of human experience -- and out of the experience of AGI systems we build.
If the line of thinking developed above is right, it follows that one way to engineer pain away would be to insert a brain implant that could trigger some sort of full or partial pain asymbolia on command. If the implant were fully activated, then the existence of pain signals would still register in the brain, and the knowledge of potential damage and danger would still arise cognitively when appropriate -- but the unconscious mind/body feeling of being damaged and endangered would be gone, and with it the quale of being in pain. If the implant were well-designed, the user could adjust their maximum or median pain level at will, in accordance with their preferences and circumstances. Potentially the user could also adjust the level of pain they feel from different sources.
Imagine if the cognitively-delivered signal "OK, I already know that mosquito bite is there, so let's end that painful itching now!" would actually be obeyed by the body ... via conscious control of a highly adaptive brain implant. It's useful to get the signal that a mosquito has bitten your body, so you know to get away from the swarm of mosquitos before you get 10000 bites and die of mosquito venom -- but once the fact of the bite has been registered in the mind, the continued painful itching serves no real value to an intelligent adult human.
This would be far better than the present situation, in which our bodies deliver us varying amounts of ouchness according to complex dynamics that are often quite loosely coupled with the deliberative, reflective parts of our minds. In the present situation, pain sensors and their neural correlates feed input to the deliberative, intensely conscious parts of our minds, but they don't heed the feedback that these conscious parts deliver. Appropriate brain implants could infuse more top-down information flow into the pain network, thus creating an overall pain processing system much better serving the overall needs of the organism.
Another possible way to get rid of pain, would be via neurofeedback. In this approach, one doesn't create implants capable of controlling brain function -- one merely tries to measure the operation of the parts of the brain concerned with ouchness, in real time. Suppose one created a hardware/software system that enabled the user to view on a computer screen, in real time, the activation of the parts of their brain concerned with causing their pain to hurt. They could do this while experimentally causing themselves various small degrees of pain. Looking at the screen, they could carry out various internal mental actions, and observe the impact each of these actions had on the activity of the ouchness-relevant parts of their brain. By doing this for a while, they would learn to control the degree of ouchness they felt. This could potentially achieve the same ends as a brain implant, but less invasively (albeit after a bunch of work).
An interesting question is what side-effects would ensue if one eliminated or drastically reduced ouchness using brain implants or neurofeedback. Would this reduce the intensity of pleasure as well? I wrote a short story with this theme some years ago -- called The Last Aphrodisiac, it centered on a future society in which everyone wore brain implants eliminating pain, but with the side-effect of dulling the intensity of pleasure as well. Then certain people disabled their brain implants, allowing themselves to experience the full joy and torture of existence as previously known by old-time humans before the era of brain implants. This is a poignant scenario to think about, but actually, what I've read about people with pain asymbolia doesn't support this sort of idea. Pain asymbolic people aren't generally unable to experience "being in pleasure", just "being in pain." There may well be various nasty side-effects to the crudest ways of disabling conventional pain qualia, but I suspect the radical diminution of pain could be achieved in far more sophisticated ways than one sees in people with natural pain asymbolia.
It would be dangerous to induce pain asymbolia or anything analogous in a young child or an animal like a dog or bird (at least, in the context of anything similar to the present situation on the planet -- radical post-Singularity scenarios aside!). This would likely lead to rapid death, as these creatures lack the knowledge and maturity to form deliberative cognitive models of their pain signals, and modulate their behavior accordingly. But at this point in my life, I know enough to stop bending over when my back sends pain signals, because I don't want to get a disabling back injury -- I don't need that annoying ouchness in order to have the sense to obey the pain signals from my back. I know enough to run away from the swarm of wasps after getting stung once, I don't need the intense unstoppable burning stinging sensation. And I definitely don't need the ouchness corresponding to the pain signals from the mouth ulcers I get from time to time -- these ones give me no value at all, but cause me annoyance and decrease my productivity.
I strongly suspect it will be possible to engineer brain implants that induce various carefully crafted, and flexibly tunable, forms of pain asymbolia. I also suspect neurofeedback, as outlined above, will be a feasible approach. Perhaps they will be combined, with neurofeedback used to learn proper control of the brain impant. Whatever the specific tools involved, once they are implemented and widely distributed, the kind of life-experience we have now, where the ouchness of pain follows us around continually threatening or tormenting us, will then be a thing of the past.
I also think it will almost surely be possible to engineer AGI systems that have little or no experience of pain. Pain asymbolia shows that it's possible even for humans, with a cognitive architecture evolved to experience the ouchness of pain, to avoid having pain hurt. So almost surely, for an AGI system engineered with minimizing ouchness as a design goal, it will be possible to do a far better job. Young human children, and humans' evolutionary predecessors, seem to have required the neural/cognitive correlates of ouchness to survive -- due to their very limited capability for deliberative, conscious cognitive modeling of damage and danger associated with pain signals. But AGI systems can potentially be created, right out of the box, with the capability to reason about damage and danger associated with their sensory inputs in a sophisticated way. They will have little need for the qualia of ouchness, and my suspicion is that their psychological health will be greater if they are engineered in such a way that these qualia are minimized. It is in human interest as well as the AGIs' interest, not to have AGIs with the bitter and tough psychology that comes about from experiencing ouchness day and and day out.
Obviously there's a lot that's not understood here. But the direction the neurospsychology of pain points us in, seems pretty clear to me. We live in an era where feeling pain and being in pain are generally the same thing, and rampant ouchness is an unavoidable quality of everyday life. But the future may be quite different -- a lot less painful. I for one am looking forward to this.
I'm sure some readers are thinking something like "Sure, it may be possible eventually to engineer something analogous to pain asymbolia! But is that really a good thing? Pain is natural! Pain is part of life! Pain makes us who we are! Without pain, won't people just do stupid things and kill or injure themselves?? Eliminating or consciously controlling pain just isn't the natural order of things -- it would mess us all up somehow!"
I've thought about these issues a lot, and ultimately -- as I alluded at the start of this article -- I concluded they're similar to the concerns some people have about the radical extension of human healthspan. Death too is natural; death too is woven all through the fabric of life as we know it.
Death helps give peoples' lives urgency, meaning, purpose. But if death were abolished or rendered far less frequent, people would find purpose and meaning through other means. And people would suffer a lot less, and be able to think deeper thoughts, love bigger loves, and create more interesting things.
Pain helps us avoid doing harmful things; and it gives a particular sort of poignancy to pleasure. But anyone with an adult human level mind is capable of avoiding doing harmful things without the ouchness factor of pain -- the reason we now require ouchness to avoid danger and damage is simply that we're accustomed to a lifetime of ouchness and cultures shaped by ouchness. And believe me, we would find plenty of ways to appreciate pleasure even without the contrast to pain. In the absence of rampant ouchness, our psychologies would certainly shift, and we would lose certain aspects of our historical "humanity." But there's no reason to believe that historically typical human experience is necessarily optimal human experience.....
It's quite possible that the total abolition of ouchness is not ideal, from a psychological or cultural perspective. But it's very hard for me to believe that evolution has supplied us with a level of ouchness that is optimal from our contemporary and future perspectives. There's just too much unnecessary and destructive pain around. Giving adult humans and AGIs conscious control over their level of ouchness is obviously the compassionate and ethical thing to do -- and it's also good mind design. How fortunate that science and engineering are likely to make this possible, and in the not extremely distant future!
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